scholarly journals Occurrence and outcomes of type 3 endoleaks in endovascular aortic repair within the Vascular Quality Initiative database

2020 ◽  
Vol 2 (1) ◽  
pp. e000054
Author(s):  
Juliet Blakeslee-Carter ◽  
Adam Beck ◽  
Emily Spangler
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Index Hospitalization ◽  
Procedural Information ◽  
Kaplan Meier ◽  
Long Term Follow Up ◽  
Clinical Consequences ◽  
Aneurysm Repair ◽  
Type 3

ObjectivesType 3 endoleaks (T3ELs) represent a lack of aneurysm protection from systemic pressure. Previous studies have found a ~2% incidence of T3EL after standard infrarenal endovascular aneurysm repair (EVAR); however, no prior studies with new-generation devices have been able to determine an association between T3EL and clinical outcomes. Here we examine T3EL within the Society for Vascular Surgery Vascular Quality Initiative (VQI) to define rates of occurrence, rates and modes of reintervention, and clinical consequences of these endoleaks.Design and settingParticipants receiving infrarenal EVAR in the VQI from January 2003 to September 2018 were analyzed in a retrospective cohort study.ParticipantsOf 42 246 entries in the EVAR procedural registry, 41 604 had complete procedural information and were included in analysis. Of these, 36 082 had long-term follow-up, and 26 422 had follow-up (9–21 months per VQI reporting standards) with complete endoleak data recorded.InterventionsAll patients included in this study underwent an infrarenal EVAR.ResultsWithin the VQI database, the rate of T3EL in infrarenal EVAR during index hospitalization was 0.37% (n=157/41 604), of which 85% were due to midgraft separation and 15% were due to fabric disruptions. Out of the 157 index hospitalization T3ELs, 4.5% (n=7) received procedural reintervention during that hospitalization, which accounted for 1% of all index hospitalization reinterventions. During the 21-month follow-up, the rate of incident T3EL was 0.7% (n=205/26 422), which accounted for 5% of all endoleaks seen during follow-up. Reinterventions for incident T3EL at follow-up were done in 30 patients (rate 0.1%), which accounted for 9% of endoleak reinterventions and 3.3% of all reinterventions. The presence of incident T3EL found during follow-up was associated with a significant decrease in 5-year survival (74% vs 80%, respectively; p=0.041) in Kaplan-Meier analysis.ConclusionT3ELs rates at placement and follow-up remain low; however, the majority reported in long-term follow-up are incident and these incident endoleaks are associated with decreased survival in EVAR.

scholarly journals PC032 Planned Perioperative Adjunctive Maneuvers Make Off-Label Endovascular Aneurysm Repair (EVAR) Comparable to Standard EVAR at a Long-Term Follow-Up

2017 ◽  
Vol 65 (6) ◽  
pp. 148S-149S
Author(s):  
Emiliano Chisci ◽  
Azzurra Guidotti ◽  
Clara Pigozzi ◽  
Eugenio Romano ◽  
Pierfrancesco Frosini ◽  
...  
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Off Label ◽  
Long Term Follow Up ◽  
Aneurysm Repair

Crossover ilio-iliac bypass and removal of femoro-femoral graft as first treatment for the infection of crossover bypass in aortouniiliac endovascular aneurysm repair

Vascular ◽  
2012 ◽  
Vol 20 (6) ◽  
pp. 306-310 ◽  
Author(s):  
Stefano Bonardelli ◽  
Franco Nodari ◽  
Maurizio De Lucia ◽  
Edoardo Cervi ◽  
Stefano Maria Giulini
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Femoral Prosthesis ◽  
Autologous Tissue ◽  
Long Term Follow Up ◽  
Crossover Bypass ◽  
Aneurysm Repair ◽  
Femoral Graft

The crossover femoro-femoral bypass, classically used for the treatment of unilateral iliac arterial obstruction, has recently become an integral part of aortouniiliac endovascular aneurysm repair. We therefore, reconsider the therapeutic problems related to thrombosis and in particular to infection of the femoro-femoral prosthesis, when many attempts have been made to preserve the bypass and treat the infection. Showing a case treated and well eight months later, we put forward the old technique of crossover ilio-iliac bypass, followed by the removal of the infected femoro-femoral graft. In our opinion, this technique circumvents the need for autologous tissue and allows for the use of prosthetics in a new, sterile, uncontaminated field. As this approach for these cases has so far not been reported in the literature, further cases and long-term follow-up are needed.

scholarly journals RS09. Very Long-Term Follow-Up (12-15 Years) of the Dutch Randomized Endovascular Aneurysm Repair Management (DREAM) Trial

2016 ◽  
Vol 63 (6) ◽  
pp. 143S ◽  
Author(s):  
Ted G. van Schaik ◽  
Jorg de Bruin ◽  
Marc van Sambeek ◽  
Hence Verhagen ◽  
Monique Prinssen ◽  
...  
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Long Term Follow Up ◽  
Aneurysm Repair

Long-term Follow-up of Secondary Interventions After Endovascular Aneurysm Repair With the AneuRx Endoprosthesis: A Single-Center Experience

2010 ◽  
Vol 17 (3) ◽  
pp. 408-415 ◽  
Author(s):  
Guus W. van Lammeren ◽  
Bram Fioole ◽  
Evert J. Waasdorp ◽  
Frans L. Moll ◽  
Joost A. van Herwaarden ◽  
...  
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Single Center ◽  
Secondary Interventions ◽  
Single Center Experience ◽  
Long Term Follow Up ◽  
Aneurysm Repair

scholarly journals FT13. Neck Dilatation After Endovascular Aneurysm Repair Rarely Exceeds the Implanted Endograft on Long-Term Follow-Up

2016 ◽  
Vol 63 (6) ◽  
pp. 20S-21S
Author(s):  
Nelson Gomes Oliveira ◽  
Frederico Bastos Gonçalves ◽  
Marie Josee Van Rijn ◽  
Frans Moll ◽  
Sander Ten Raa ◽  
...  
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Long Term Follow Up ◽  
Aneurysm Repair

scholarly journals Outcomes of Advanta V12 Covered Stents After Fenestrated Endovascular Aneurysm Repair

2021 ◽  
pp. 152660282110164
Author(s):  
Claire van der Riet ◽  
Richte C. L. Schuurmann ◽  
Eric L. G. Verhoeven ◽  
Clark J. Zeebregts ◽  
Ignace F. J. Tielliu ◽  
...  
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Aortic Aneurysms ◽  
Stent Fracture ◽  
Covered Stents ◽  
Significant Stenosis ◽  
Primary Endpoints ◽  
Visceral Arteries ◽  
Aneurysm Repair ◽  
Type 3

Purpose: Fenestrated endovascular aneurysm repair (FEVAR) is a well-established endovascular treatment option for pararenal abdominal aortic aneurysms in which balloon-expandable covered stents (BECS) are used to bridge the fenestration to the target vessels. This study presents midterm clinical outcomes and patency rates of the Advanta V12 BECS used as a bridging stent. Methods: All patients treated with FEVAR with at least 1 Advanta V12 BECS were included from 2 large-volume vascular centers between January 2012 and December 2015. Primary endpoints were freedom from all-cause reintervention, and freedom from BECS-associated complications and reintervention. BECS-associated complications included significant stenosis, occlusion, type 3 endoleak, or stent fracture. Secondary endpoints included all-cause mortality in-hospital and during follow-up. Results: This retrospective study included 194 FEVAR patients with a mean age of 72.2±8.0 years. A total of 457 visceral arteries were stented with an Advanta V12 BECS. Median (interquartile range) follow-up time was 24.6 (1.6, 49.9) months. The FEVAR procedure was technically successful in 93% of the patients. Five patients (3%) died in-hospital. Patient survival was 77% (95% CI 69% to 84%) at 3 years. Freedom from all-cause reintervention was 70% (95% CI 61% to 78%) at 3 years, and 33% of all-cause reinterventions were BECS associated. Complications were seen in 24 of 457 Advanta V12 BECSs: type 3 endoleak in 8 BECSs, significant stenosis in 4 BECSs, occlusion in 6 BECSs, and stent fractures in 3 BECSs. A combination of complications occurred in 3 BECSs: type 3 endoleak and stenosis, stent fracture and stenosis, and stent fracture and occlusion. The freedom from BECS-associated complications for Advanta V12 BECSs was 98% (95% CI 96% to 99%) at 1 year and 92% (95% CI 88% to 95%) at 3 years. The freedom from BECS-associated reinterventions was 98% (95% CI 95% to 100%) at 1 year and 94% (95% CI 91% to 97%) at 3 years. Conclusion: The Advanta V12 BECS used as bridging stent in FEVAR showed low complication and reintervention rates at 3 years. A substantial number of FEVAR patients required a reintervention, but most were not BECS related.

Atrial fibrillation associated with increased risk of venous thromboembolism

2015 ◽  
Vol 113 (01) ◽  
pp. 185-192 ◽  
Author(s):  
Chun-Cheng Wang ◽  
Cheng-Li Lin ◽  
Guei-Jane Wang ◽  
Chiz-Tzung Chang ◽  
Fung-Chang Sung ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Venous Thromboembolism ◽  
Incidence Rates ◽  
Vein Thrombosis ◽  
Kaplan Meier ◽  
Increased Risk ◽  
Long Term Follow Up ◽  
Deep Vein

SummaryWhether atrial fibrillation (AF) is associated with an increased risk of venous thromboembolism (VTE) remains controversial. From Longitudinal Health Insurance Database 2000 (LHID2000), we identified 11,458 patients newly diagnosed with AF. The comparison group comprised 45,637 patients without AF. Both cohorts were followed up to measure the incidence of deep-vein thrombosis (DVT) and pulmonary embolism (PE). Univariable and multivariable competing-risks regression model and Kaplan-Meier analyses with the use of Aelon-Johansen estimator were used to measure the differences of cumulative incidences of DVT and PE, respectively. The overall incidence rates (per 1,000 person-years) of DVT and PE between the AF group and non-AF groups were 2.69 vs 1.12 (crude hazard ratio [HR] = 1.92; 95 % confidence interval [CI] = 1.54-2.39), 1.55 vs 0.46 (crude HR = 2.68; 95 % CI = 1.97-3.64), respectively. The baseline demographics indicated that the members of the AF group demonstrated a significantly older age and higher proportions of comorbidities than non-AF group. After adjusting for age, sex, and comorbidities, the risks of DVT and PE remained significantly elevated in the AF group compared with the non-AF group (adjusted HR = 1.74; 95 %CI = 1.36-2.24, adjusted HR = 2.18; 95 %CI = 1.51-3.15, respectively). The Kaplan-Meier curve with the use of Aelon-Johansen estimator indicated that the cumulative incidences of DVT and PE were both more significantly elevated in the AF group than in the non-AF group after a long-term follow-up period (p<0.01). In conclusion, the presence of AF is associated with increased risk of VTE after a long-term follow-up period.

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